Miscarriage stories of loss, hope and help. It's always devastating to experience a loss. It can cause you to feel alone, isolated. There's no 'right' way to feel - a range of reactions are possible and normal. In addition to the grief you may feel, your body will be undergoing some profound hormonal adjustments, which may make you feel very emotionally volatile. If you have had a miscarriage, take the time to understand better why these occur and why it is not your fault.

Tuesday, February 19, 2008

Specialists Trying to Unravel the Mystery of Miscarriage

The first time Patricia McCreary became pregnant, she had a baby.

"I look at that now as this naïve bliss time, when I thought pregnancy meant a baby," said Ms. McCreary, who lives in Seattle.

But five years and four miscarriages later, she said, "When I hear someone say, 'I'm pregnant,' to me it's like, fear and dread and when am I going to get my heart smashed."

The agony of infertility for thousands of American women is not that they cannot conceive, but that they cannot hold on to their babies beyond the first few weeks of pregnancy - and no one can explain why.

Doctors say that as many as 3 or 4 percent of couples who try to have children suffer from what doctors call recurrent pregnancy loss, in which women younger than 40 experience three or more consecutive miscarriages with the same partner.

A fourth of those couples, doctors say, will probably remain in the "don't know why" category. Researchers at the Centers for Disease Control and Prevention estimate that of the 6.23 million pregnancies recorded in the United States in 1999, 1 million ended in miscarriage. A 25-year-old has a 15 percent chance of miscarrying. By 42, that figure exceeds 50 percent.

Miscarriages, though common, are rarely discussed. Nor have they been much studied until recently.

Other causes of recurrent pregnancy loss include anatomical abnormalities in the uterus, diseases of the immune system, hormonal imbalances and problems with blood clotting. Infections and, more rarely, chromosomal abnormalities in a parent, can also be factors.

Patients and doctors say that treatments can differ wildly from practice to practice and that there is only a limited consensus on how to address unexplained recurrent pregnancy loss.

Even a treatment as venerable as progesterone, a hormone vital to a healthy pregnancy, is divisive. Some doctors swear that it helps. Others argue that it does nothing but postpone an inevitable miscarriage. New research suggests that very high doses of progesterone may be effective in some cases, probably a result of the hormone's immunosuppressive effects.

"How many patients do we save from miscarriage with progesterone supplements?" Dr. Alan B. Copperman, director of reproductive endocrinology and infertility at the Mount Sinai Medical Center, asked. "Not that many. Do we do it routinely? Sure we do. It's a mostly harmless, inexpensive treatment, which a lot of patients go on. But it probably doesn't save that many pregnancies."

Dr. Kutteh said that when he was a student 15 years ago "there was no training on pregnancy loss."

"It's just one of those areas where there wasn't much known," he added. "And there were not many experts, and there was not a consensus on what to do."

Now, he said, more than 25 training programs turn out about 50 specialists a year.

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